State of newborn health in India (original) (raw)
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Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine, 2021
Background: The Government of India initiated different programs to reduce neonatal mortality. However, the variability of neonatal deaths occurs among states of India. Objective: This study aimed to identify the differential determinants associated with neonatal deaths in northern and southern regions of India. Materials and Methods: Bivariate analysis and Cox regression analysis have been performed to evaluate the predictors of neonatal mortality from National Family Health Survey (NFHS-4) data. Results: For neonatal mortality, mother and child factors became more consistent in the southern region than northern regions of the country, while household factor was almost the same in both regions of India. Conclusions: Primary intervention is also required to reduce public health problem as neonatal mortality. It should be focused on education of mother, birth interval, age at birth, antenatal care, poverty reduction programs, and proper heath facility to pregnant mothers.
Determinants of neonatal mortality in rural India, 2007-08
2013
Background. Despite the growing share of neonatal mortality in under-5 mortality in the recent decades in India, most studies have focused on infant and child mortality putting neonatal mortality on the back seat. The development of focused and evidence-based health interventions to reduce neonatal mortality warrants an examination of factors affecting it. Therefore, this study attempt to examine individual, household, and community level factors affecting neonatal mortality in rural India. Data and methods. We analysed information on 171,529 singleton live births using the data from the most recent round of the District Level Household Survey conducted in 2007-08. Principal component analysis was used to create an asset index. Two-level logistic regression was performed to analyse the factors associated with neonatal deaths in rural India. Results. The odds of neonatal death were lower for neonates born to mothers with secondary level education (OR = 0.60, p = 0.01) compared to those born to illiterate mothers. A progressive reduction in the odds occurred as the level of fathers' education increased. The odds of neonatal death were lower for infants born to unemployed mothers (OR = 0.89, p = 0.00) compared to those who worked as agricultural worker/farmer/laborer. The odds decreased if neonates belonged to Scheduled Tribes (OR = 0.72, p = 0.00) or 'Others' caste group (OR = 0.87, p = 0.04) and to the households with access to improved sanitation (OR = 0.87, p = 0.02), pucca house (OR = 0.87, p = 0.03) and electricity (OR = 0.84, p = 0.00). The odds were higher for male infants (OR = 1.21, p = 0.00) and whose mother experienced delivery complications (OR = 1.20, p = 0.00). Infants whose mothers received two tetanus toxoid injections (OR = 0.65, p = 0.00) were less likely to die in the neonatal period. Children of higher birth order were less likely to die compared to first birth order. Conclusion. Ensuring the consumption of an adequate quantity of Tetanus Toxoid (TT) injections by pregnant mothers, targeting vulnerable groups like young, first time and Scheduled Caste mothers, and improving overall household environment by increasing access to improved toilets, electricity, and pucca houses could also contribute to further reductions in neonatal mortality in rural India. Any public health interventions aimed at reducing neonatal death in rural India should consider these factors.
Determinants of neonatal mortality in rural India, 2007–2008
Background. Despite the growing share of neonatal mortality in under-5 mortality in the recent decades in India, most studies have focused on infant and child mortality putting neonatal mortality on the back seat. The development of focused and evidence-based health interventions to reduce neonatal mortality warrants an examination of factors affecting it. Therefore, this study attempt to examine individual, household, and community level factors affecting neonatal mortality in rural India. Data and methods. We analysed information on 171,529 singleton live births using the data from the most recent round of the District Level Household Survey conducted in 2007-08. Principal component analysis was used to create an asset index. Two-level logistic regression was performed to analyse the factors associated with neonatal deaths in rural India. Results. The odds of neonatal death were lower for neonates born to mothers with secondary level education (OR = 0.60, p = 0.01) compared to those born to illiterate mothers. A progressive reduction in the odds occurred as the level of fathers' education increased. The odds of neonatal death were lower for infants born to unemployed mothers (OR = 0.89, p = 0.00) compared to those who worked as agricultural worker/farmer/laborer. The odds decreased if neonates belonged to Scheduled Tribes (OR = 0.72, p = 0.00) or 'Others' caste group (OR = 0.87, p = 0.04) and to the households with access to improved sanitation (OR = 0.87, p = 0.02), pucca house (OR = 0.87, p = 0.03) and electricity (OR = 0.84, p = 0.00). The odds were higher for male infants (OR = 1.21, p = 0.00) and whose mother experienced delivery complications (OR = 1.20, p = 0.00). Infants whose mothers received two tetanus toxoid injections (OR = 0.65, p = 0.00) were less likely to die in the neonatal period. Children of higher birth order were less likely to die compared to first birth order. Conclusion. Ensuring the consumption of an adequate quantity of Tetanus Toxoid (TT) injections by pregnant mothers, targeting vulnerable groups like young, first time and Scheduled Caste mothers, and improving overall household environment by increasing access to improved toilets, electricity, and pucca houses could also contribute to further reductions in neonatal mortality in rural India. Any public health interventions aimed at reducing neonatal death in rural India should consider these factors.
The neonatal (NNMR) and post neonatal mortality (PNNMR) together constitutes the infant mortality rate (IMR) which is regarded as an important indicator of health status of a community and judge the effectiveness of intervention programmes. India has the highest number of neonatal deaths in the world and it accounts for 56 percent of under-five child mortality. Over the last 42 years, IMR, NNMR and PNNMR have declined and share of NNMR and PNNMR to IMR has changed. Therefore, the present exercise has been done to find out the trends of IMR and its components and trend of share of these components in India and its selected states. The study found that the pace of decline in infant mortality has quickened in recent years. The post-neonatal deaths have declined faster resulting in faster decline in IMR and the neonatal deaths recorded only a modest reduction.
INTER-STATE VARIATION IN NEONATAL MORTALITY RATE AMONG INDIAN STATES
National Journal of Community Medicine, 2013
Background: Infant Mortality Rate has been accepted as an important indicator of overall health status of community and has also been included in millennium development goal indicators. The study was conducted to find the: Association of neonatal mortality rate with different risk factors and association of neonatal mortality rate with various interventional variables Methods: This study uses data from Indian National Family Health Survey -3 (NFHS-3). Sample for analysis includes all 29 states of India in which third round of National Family Health Survey were conducted and reports for the same were available. Data was obtained from state reports of National Family Health Survey -3.Neonatal mortality rates of different states were taken as dependent variable. Results: Bi-variate regression showing influence of percentage of women age 15-19 years who have begun childbearing and percentage of women with BMI < 17 on neonatal mortality was confounding effect of socio-economic status. Bi-variate regression showing influence of ante-natal check up, iron-folic acid supplementation and post natal check up on neonatal mortality was confounding effect of socio-economic status. Conclusions and Recommendations: The only variable other than socio-economic condition which was having association with neonatal mortality rate was percentage of hospital delivery. Government of India should take all possible measures to make health care services particularly facility based services available, accessible and affordable.
High Neonatal Mortality Rates in Rural India: What Options to Explore?
ISRN Pediatrics, 2012
The neonatal mortality rate in India is amongst the highest in the world and skewed towards rural areas. Nonavailability of trained manpower along with poor healthcare infrastructure is one of the major hurdles in ensuring quality neonatal care. We reviewed case studies and relevant literature from low and middle income countries and documented alternative strategies that have proved to be favourable in improving neonatal health. The authors reiterate the fact that recruiting and retaining trained manpower in rural areas by all means is essential to improve the quality of neonatal care services. Besides this, other strategies such as training of local rural healthcare providers and traditional midwives, promoting home-based newborn care, and creating community awareness and mobilization also hold enough potential to influence the neonatal health positively and efforts should be made to implement them on a larger scale. More research is demanded for innovations such as "m-health" and public-private partnerships as they have been shown to offer potential in terms of improving the standards of care. The above proposed strategy is likely to reduce morbidity among neonatal survivors as well.
Reproductive Health
Background Neonatal mortality causes a substantial proportion of the under-5 mortality in low and middle-income countries (LMIC). Methods We undertook a prospective, population-based research study of pregnant women residing in defined geographic areas in the Karnataka State of India, a research site of the Global Network for Women’s and Children’s Health Research. Study staff collected demographic and health care characteristics on eligible women enrolled with neonatal outcomes obtained at delivery and day 28. Cause of neonatal mortality at day 28 was assigned by algorithm using prospectively defined variables. Results From 2014 to 2018, the neonatal mortality rate was 24.5 per 1,000 live births. The cause of the 28-day neonatal deaths was attributed to prematurity (27.9%), birth asphyxia (25.1%), infection (23.7%) and congenital anomalies (18.4%). Four or more antenatal care (ANC) visits was associated with a lower risk of neonatal death compared to fewer ANC visits. In the adjust...
Neonatal morbidity and mortality in tribal and rural communities in Central India
Little is known about the natural history of neonates born in the rural and tribal areas in India. The Neonatal Disease Surveillance Study (NDSS) measures the incidence of high-priority neonatal diseases, neonatal health events and associated risk factors to plan appropriate and effective actions. Materials and Methods: The NDSS is being conducted in Ramtek Revenue Block, Nagpur district, Maharashtra state, given its considerably high level of neonatal mortality. All households from five selected primary health centers were screened. Both active and passive surveillance systems were used for systematic collection of mother's health during pregnancy and of baby's health from birth to 4 months after birth. First-year results from November 2006 to October 2007 are presented. Results: Pregnancy outcomes were available for 1,136 women, with an overall neonatal mortality of 73 per 1,000 live births. The pregnancy outcomes varied by gestational age of the baby; miscarriages and abortions were higher in tribal than in non-tribal women, and tribal women had higher rates of low-birth weight (LBW) neonates than non-tribal women. The main cause of neonatal mortality was LBW, followed by sepsis and respiratory illness. The mortality of non-tribal babies was most strongly associated with pre term. For tribal babies, mortality was also associated with maternal morbidity and delay in the initiation of breastfeeding. Interpretation and Conclusions: The NDSS provides valuable information on the potentially modifiable factors associated with increased likelihood of neonatal mortality and morbidity. The Neonatal Health Research Initiative is now developing community-based interventions to reduce the high rate of neonatal mortality and morbidity in the rural areas of India.
Infant and child mortality in India
pdf.usaid.gov, 1998
This Subject Report exammes mfant and child mortality and their determinants for India as a whole and for mdlvldual states, usmg data from the 1992-93 NatIOnal Family Health SUNey Neonatal (first month), postneonatal (age 1-11 months), mfant (first year), ...